Guillain-Barre Syndrome Following Spinal Fusion for Thoracic Vertebral Fracture

Abstract

There have been very few reports in the literature of Guillain-Barré syndrome (GBS) after spinal surgery. We present a unique case of GBS following spinal fusion for thoracic vertebral fracture. The aim of this report is to illustrate the importance of early neurological assessment and determining the exact cause of a new neurological deficit that occurs after an operation.

A Rare Complication of Spine Surgery: Guillain–Barré Syndrome

“…During the past decades, there have been a number of reports presenting GBS following different types of surgery (3)(4)(5)(6)(7)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18), but only 5 of the cases (3-7) developed the complication 8 to 22 days after spine surgery ( Table 4). The 4 post-spinal-surgery GBS we observed were out of a total of 7770 cases; the incidence of GBS after spine surgery is 1 per 2,000 (4/7770).…”

“…The onset of complications ranges from 4% to 19% (1), among which the overall incidence of neurologic complications is less than 1% (2). Guillain-Barré syndrome (GBS), one type of neurologic complications following spinal operation, has rarely been reported (3)(4)(5)(6)(7).…”

Development of Acute Inflammatory Demyelinating Polyneuropathy 11 Days after Spinal Surgery: A Case Report and Literature Review

“…Their average age was 56.8 years (range, 33–73 years), and the male/female ratio was 11/7 [ 11 – 24 ]. The vertebral regions affected by the surgery were the lumbar region in eight (44.4%) patients [ 16 , 17 , 20 – 24 ], the cervical region in four (22.2%) [ 15 , 18 ], the thoracolumbar region in three (16.7%) [ 11 , 14 , 18 ], the thoracic region in one (5.6%) [ 13 ], the thoracosacral region in one (5.6%) [ 11 ], and the lumbosacral region in one (5.6%) [ 19 ]. The average duration of time from spinal surgery to the onset of GBS symptoms was 7.4 days (range, 1 hour to 22 days), with two patients having a duration of ≤3 hours [ 17 ], and the duration of time from onset of GBS symptoms to diagnosis was 7.2 days (range, 1–19 days).…”

“…The average duration of time from spinal surgery to the onset of GBS symptoms was 7.4 days (range, 1 hour to 22 days), with two patients having a duration of ≤3 hours [ 17 ], and the duration of time from onset of GBS symptoms to diagnosis was 7.2 days (range, 1–19 days). Ten (55.6%) patients had motor weakness at the nadir in the lower limbs only [ 11 , 15 , 17 – 20 , 22 – 24 ], and eight (44.4%) had motor weakness in the upper and lower limbs [ 12 – 14 , 16 – 18 , 21 ]. Seven (38.9%) patients had sensory deficits at the nadir in the lower limbs only [ 11 , 16 , 17 , 20 , 22 – 24 ], five (27.8%) in the upper and lower limbs [ 12 , 13 , 15 , 17 , 19 ], and one (11.1%) in the upper limbs only [ 14 ].…”

“…Ten (55.6%) patients had motor weakness at the nadir in the lower limbs only [ 11 , 15 , 17 – 20 , 22 – 24 ], and eight (44.4%) had motor weakness in the upper and lower limbs [ 12 – 14 , 16 – 18 , 21 ]. Seven (38.9%) patients had sensory deficits at the nadir in the lower limbs only [ 11 , 16 , 17 , 20 , 22 – 24 ], five (27.8%) in the upper and lower limbs [ 12 , 13 , 15 , 17 , 19 ], and one (11.1%) in the upper limbs only [ 14 ]. Eleven (61.1%) patients showed areflexia or hyporeflexia [ 11 – 17 , 20 – 23 ].…”